腹泻型、便秘型肠易激综合征和功能性便秘患者的直肠肛管测压比较  

Differences of Anal Manometry Among Dirrhea-dominant,Constipation-dominant Irritable Bowel Syndrome and Functional Constipation

作　　者：刘玉兰[1] 肖文斌[1] 赵丽莉[1] 

机构地区：[1]北京大学人民医院消化科,北京100044

出　　处：《中国医师杂志》2003年第7期895-897,共3页Journal of Chinese Physician

摘　　要：目的　研究腹泻型、便秘型IBS和功能性便秘患者直肠肛管测压参数的不同 ,并评价性别和年龄对各项参数的影响。方法　腹泻型IBS( n =18)、便秘型IBS( n =14 )、功能性便秘 ( n =3 0 )和健康对照组 ( n =18) ,通过定点牵拉法进行直肠肛管测压。结果　腹泻型IBS、便秘型IBS、功能性便秘以及健康对照组直肠肛管测压各项压力参数基本无差异 ,但三组患者的诱发RAIR所需的最小气体容量均显著高于健康对照组 ,便秘型IBS和功能性便秘模拟排便时发生矛盾运动的百分比显著高于腹泻型IBS和健康对照组 ;便秘型IBS和功能性便秘组中 ,肛管上部和下部最大紧缩压力 ,以及模拟排便发生矛盾运动的百分比男性均高于女性 ;腹泻型IBS组内男性模拟排便发生矛盾运动的百分比高于女性 ;健康对照组内男性肛管下部静息压力和最大紧缩压力高于女性 ;各组 2 0～ 5 0岁人群和 5 0～ 80岁人群的各项压力参数无显著性差异 ,但功能性便秘组青年组诱发RAIR所需的最小气体容量低于老年组。结论　腹泻型IBS、便秘型IBS和功能性便秘患者的直肠肛管测压各项压力参数无助于这三型功能性肠病的鉴别诊断。男性的直肠肛管测压的多项压力参数显著高于女性 ,男性更易出现模拟排便矛盾运动 。Objective To study the differences of anal manometry among dirrhea-dominant(DD), constipation-dominant(CD) irritable bowel syndrome(IBS) and functional constipation(FC), and to evaluate effects of sex and age on these parameters.Methods Age-matched 18 DD-IBS, 14 CD-IBS and 30 FC patients were selected, and 18 volunteers as healthy controls. Anal manometry was evaluated with localized point pull-extraction technique.Results The pressure parameters in DD-IBS, CD-IBS and FC were no significantly difference from those in healthy controls, but the threshold volume of gas to induce RAIR was significantly larger(P<0 05).In CD-IBS and FC groups, the squeeze pressure of upper and lower anal canal of males was higher than those of females, as was the frequency of paradox movement. There was no differences in all parameters between younger and olderly patients expcept the gas threshold volume to induce RAIR which of younger was smaller.Conclusions Various pressure paremeters in differentiating DD-IBS, CD-IBS, FC from healthy controls could not value in clinic.The pressure parameters in women was significantly lower than those in men. Age has not effect on anal manometry.

关 键 词：腹泻型肠易激综合征 便秘型肠易激综合征 功能性便秘 直肠肛管测压 最小气体容量 静息压力 最大紧缩压力 

分 类 号：R574[医药卫生—消化系统] R442.2[医药卫生—内科学]